Trying to ConceiveFertilityPhysical healthTTC healthWellbeing
Understanding your fertility test results is another significant aspect of the fertility journey. We in our clinic have a very comprehensive fertility testing protocol that we use with patients participating in the Fertility BreakthroughTM program. There are at least 50 parameters or tests that may need to be performed for a couple experiencing fertility problems, in order to rule out possible reasons or causes of infertility.Having tests done is important, but so is the quality of the actual testing. So where to go for fertility tests? We highly recommend going to a specialist fertility laboratory, as opposed to a general one. The former offers a much higher and advanced testing, that will give you a better understanding of where your fertility is at.In this article, we are going to talk about the essential tests in gauging fertility — emphasizing four fertility tests for both partners. If we can only request for some tests, we will absolutely make sure to order them.

Thyroid function test and thyroid antibodies

Who to take: FemalesWhen to take: Any time in the cycleWhat is it for: Proper thyroid function is vital for ensuring the mother’s and the developing embryo’s metabolism both work effectively. The risks of miscarriage and developmental complications in the fetus are likely to be increased by strain on the hypothalamus-pituitary- thyroid axis (often present in cases of female infertility). Read Thyroid, fertility, and miscarriages for more insights.Similarly, permanent thyroid damage can occur as a result of thyroid antibodies. If this is happening, it is important to find out and use other methods necessary to ensure the thyroid does not become the reason for infertility — and even recurrent spontaneous abortions.[1-5] Read Insight into thyroid tests? for more information.

Vaginal swab and culture

Who to take: FemalesWhen to take: Any time in the cycleWhat is it for: There are infections to be ruled out, which can negatively impact a couple’s ability to conceive and a woman’s ability to keep a healthy pregnancy to term. These can also affect pregnancy in its very early stages.In addition, many of the sexually transmitted infections pose a very real concern to a developing pregnancy and embryo. It is recommended that a woman has a high vaginal swab performed by her general practitioner (GP) or specialist, that includes general culture and specifically ureaplasma and mycoplasma.[6-8]

Follicle-stimulating hormone (FSH) test

Who to take: FemalesWhen to take: Day 2 of cycleWhat is it for: All the relevant hormonal tests must be done to ascertain appropriate balance for optimum results. Without the suitable amount of estrogen, eggs do not mature effectively.High follicle-stimulating hormone (FSH) levels suggest possible ovarian failure, or compromised ovarian function. Luteinizing hormone (LH):FSH ratio imbalances can lead to a diagnosis of polycystic ovarian syndrome (PCOS), even when the menstrual cycle is regular. For a similar reason, dehydroepiandrosterone (DHEA), testosterone, free androgen index (FAI), and sex hormone binding globulin (SHBG) are also necessary to be tested.[9-11]An anti-mullerian hormone (AMH) test is also useful to ovarian research (i.e. the quantity of eggs left — it gives no clue as to the quality of the eggs). Read AMH is NOT a marker of quality of eggs for more insights. Others to be tested are prolactin which guarantees pituitary function for proper signalling and overall hormonal balance, as well as progesterone to discover its baseline.[12-14]If only one test can be ordered out of all these, it will be FSH. If a woman’s FSH levels are too high, a pregnancy is unlikely to occur without treatment.[15]

Semen analysis

Who to take: MalesWhen to take: Anytime (and as soon as possible)What is it for: It is vital to have your semen analysis performed at a specialist fertility or IVF laboratory.In addition, we will request an immunobead test (IBT) to rule out antisperm antibodies. We will also order a sperm chromatin structure (SCSA), DNA fragmentation test, and semen culture to rule out possible infections. This is the best way to ensure male fertility is optimum, so that any couple can achieve peak fertility.[16,17]

Final thoughts

Understanding your fertility test results is one of the things we tackle in the Fertility ChallengeTM program.Fertility test results are also one of the first things we address in our clinic when working with patients. If you want to have a chat with our team to know if we can be of help to your specific fertility situation, contact us via the 'Contact' button on my profile.  

References:

[1] Cho, M.K. Thyroid dysfunction and subfertility. Clinical and Experimental Reproductive Medicine, 2015. 42(4). PMID: 26816871. [2] Ding, X., et al. Subclinical Hypothyroidism in Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis. Frontiers in Endocrinology, 2018. PMID: 30542323. [3] Fallatah, A.M., et al. Pregnancy Outcomes among Obese Pregnant Women with Hypothyroidism: Medical Record Review of a Single Tertiary Center in Saudi Arabia. Cureus, 2020. 12(2). PMID: 32190490. [4] Zhang, Y., et al. Patients With Subclinical Hypothyroidism Before 20 Weeks of Pregnancy Have a Higher Risk of Miscarriage: A Systematic Review and Meta-Analysis. PLoS One, 2017. 12(4). PMID: 28414788. [5] Jølving, L.R., et al. The chance of a live birth after assisted reproduction in women with thyroid disorders. Clinical Epidemiology, 2019. PMID: 31496823. [6] Piscopo, R.C.C.P., et al. Increased prevalence of endocervical Mycoplasma and Ureaplasma colonization in infertile women with tubal factor. JBRA Assisted Reproduction, 2020. 24(2). PMID: 32031768. [7] Moragianni, D., et al. Genital tract infection and associated factors affect the reproductive outcome in fertile females and females undergoing in vitro fertilization. Biomedical Reports, 2019. 10(4). PMID: 30972218. [8] Ricci, S., et al. Impact of Asymptomatic Genital Tract Infections on in Vitro Fertilization (IVF) Outcome. PLoS One, 2018. 13(11). PMID: 30444931. [9] Orlowski, M., et al. Physiology, Follicle Stimulating Hormone. StatPearls, 2020. PMID: 30571063. [10] François, C.M., et al. A Novel Action of Follicle-Stimulating Hormone in the Ovary Promotes Estradiol Production Without Inducing Excessive Follicular Growth Before Puberty. Scientific Reports, 2017. Affiliations expand PMID: 28397811. [11] Chun, S. Serum luteinizing hormone level and luteinizing hormone/follicle-stimulating hormone ratio but not serum anti-Müllerian hormone level is related to ovarian volume in Korean women with polycystic ovary syndrome. Clinical and Experimental Reproductive Medicine, 2014. 41(2). PMID: 25045633. [12] Tal, R., et al. Ovarian Reserve Testing: A User's Guide. American Journal of Obstetrics and Gynecology, 2017. 217(2). PMID: 28235465. [13] Pałubska, S., et al. Hyperprolactinaemia – a problem in patients from the reproductive period to the menopause. Menopause Review, 2017. 16(1). PMID: 28546800. [14] Messen, T.B., et al. Progesterone and the Luteal Phase. Obstetrics and Gynecology Clinics of North America, 2015. 42(1). PMID: 25681845. [15] Ebbiary, N.A.A., et al. The Significance of Elevated Basal Follicle Stimulating Hormone in Regularly Menstruating Infertile Women. Human Reproduction, 1994. 9(2). PMID: 8027280. [16] Vasan, S.S., et al. Semen analysis and sperm function tests: How much to test? Indian Journal of Urology, 2011. 27(1). PMID: 21716889. [17] Oehninger, S., et al. Sperm Functional Tests. Fertility and Sterility, 2014. 102(6). PMID: 25450304.
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